To my bloggers:
My article on Epigenetics and Primal Therapy will appear in the Activitas Nervosa Superior (ANS), a journal for neurocognitive research of the World Psychiatric Association (http://www.activitas.org/index.php/nervosa). I will also publish it on my blog as a series over a month or two, as it is 80 pages long. It is the most important article I have ever written and I hope it will change the science of psychotherapy; this is, begin to turn it into a real science.
Thursday, January 3, 2013
Can I Hurt Your Feelings?
I have long maintained that this was impossible since feelings can hurt but cannot be hurt. It is like an oxymoron: how can we hurt something that is already hurt? What we usually mean is that something we said sets off something in someone else that pains them. Then they hurt, usually only when what we said resonates with some hidden pain. If we say, “You are wrong. You made a mistake,” it can set off years of criticism by one’s mother who demonstrated in this way that she hated us. Therefore any criticism hurts our feelings when it sets off already hurt feeling buried inside of us. So it is not, “I hurt her feelings;” it is “ I said something that triggered hurt feelings inside”.
Let’s look at this from another perspective. We have a brain structure called the dorsal anterior cingulate cortex (dACC). It is central to our limbic system/feeling center. When we begin to feel isolated or neglected this structure takes part and adds the “hurt” to our reaction. It becomes part of our pain network. (see: New Scientist, 1, Dec. 2012, page 37). This structure adds the force, valence or oomph to our reactions. But when we hurt emotionally there is another group of structures, the sensory group, (the anterior insula and others) that enter the fray and helps the emotions become physical hurt. They become intertwined and are “one.” Feeling neglected hurts both emotionally and physically. Emotional hurts, in short, have bodily accouterments; which is obvious. So when our feelings are hurt we hurt physically: it is not simply “in our head.” And therefore “head” therapy or cognitive approaches cannot touch it. Remember, we are in pain.
When we say that “breaks my heart,” it is literally true, and it can kill as readily as a gunshot. I have on film a woman I treated who was feeling deeply and who cried out, “my heart, my heart.” When she came out of it she felt her childhood heartbreak (sent to a foster home) and how much it affected her heart. Normally, repression keeps that from happening, except that repression does not erase it; it only drives it underground. It is repressed feelings that can kill us; for they do affect our organs, especially our heart. There is no escape; either we feel or we suffer. Pills can sometimes take care of parts of our hurt but they only suppress the conscious/awareness of the hurt, not the hurt itself nor its provenance.
Very early trauma can affect (mutate) a gene that helps construct opiate receptors that should dampen pain. And that can therefore exacerbate our reactions to hurt early on. (receptors are very dense in the dACC). We become more “sensitive” as human beings. It becomes part of our personality. These people need more opiates later on to make up for what was and is missing. They may be the “over-reactors.” And then we can add the epigenetic factors, traumas that occur while we live in the womb and just after, which compounds the problem. We then suffer, compounded, chronic pain; it may not show itself as such, but it can manifest itself in chronic allergies, which was my case. I had a runny nose that lasted years after I was sent away to a foster home when I was five. I knew nothing about pain. We see patients all of the time who claim never to have been in pain or feeling unloved; at least at first.
So we have genetic mutations coupled with epigenetic factors that compound the problem and produce highly sensitive beings. They were known by Freud as “hysterics.” The memories are imprinted and stay for a lifetime because we are then structurally different. So lack of love in the womb (a carrying mother who diets, smokes and drinks and who is chronically anxious), remains as a new part of us with a different brain and biochemistry. Not only is the anterior cingulate active in the anxious, carrying mother but no doubt the fetus is in the same physiologic state. I have written about this in my Life Before Birth, where the fetus’s biochemistry reflects the mother’s. And this is why we think it is due to heredity, and in a sense it is, and in a another sense, it is not. But this can produce chronic inflammation and associated diseases. The inflammation response is getting the body ready to combat intrusion, except that here the intrusion is from the pain trespassing into our system and our brains. It is a lethal trespasser that alters our neuro-physical being for a lifetime. It is not just our ideas that changes; it is our physical being that long predates the development of ideas. And we carry that hurt around all of the time. It first changes our bodies and then we when we have the capacity for ideas it changes them too. Here the lower level imprints send their messages upward and forward diverting ideas.
We begin to see how complicated all this is because when we want to find out what causes severe addiction we need to be able to look way back and far earlier than we imagined. There is a controversy as to how much of homosexuality could be genetic or epigenetic. Many homosexuals I know and have treated insist that it is genetic; but after seeing all this new research we see how early deviations begin both in the brain and physical system. So it is hard to know how much is genetic and how much isn’t. I still opt for epigenetics as a major influence. This may be added to genetic mutations very early on. Then there is more trauma and environmental influences are dominant. This is very true in the addictions I have seen. The earlier the trauma the more enduring and heavier the addiction, in my opinion, and in my experience. So when we use Behavioral therapy to treat all this we are far from the target. And years away from it and many millions of years distant in phylogenetic time.
There can be all kinds of mutations of genes early on, we are discovering that form the matrix for personality. For example, there is the cholinergic gene that when affected can alter how we learn later on. It again affects reactivity and how sensitive we become. This is the “mother” of the production of acetylcholine. It affects our ability to pay attention. The more the release the less ability to modulate and restrain our behavior. The greater the release the lower the threshold for nerve firing; in brief, the greater our reactivity and lower restraint and control. All this is heavily compounded by trauma during our life in the womb. So we have these very early settings for later personality; whether we are impulsive or over-restrained. Whether we speak our mind or hold everything in. Whether we are normally sexual or we are frigid; do we suffer premature ejaculation or have delayed orgasm.
There is something I left out: not only does the mother’s cells affect the baby, her emotional state and her moods but the contrary is true; the fetal cells affect the mother. A piece in Scientific American (December 2012) found that fetal cells in animals migrate into the mother and can act very much like stem cells; they can migrate in the mother to where there is injury and help the healing process. So it is a two-way street. The baby is a great help to the mother. Let’s watch the developing research on this.
So we note that very early experience changes brain structure and affects the developing neurons that already almost complete in the womb. When we want to understand the causes of allergies, migraines, asthma and high blood pressure we need to look in the right place and in the right epoch. We must not forget that epigenetic factors, life in the womb, can turn on and off key genes; this causes further transformation of our biology. So yes we are products of our genes and what happens to those genes along the way. The question is: are we only products of genes and epigenes? Is there free will? Not much.
Quotes for "Life Before Birth"
“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine
Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University
Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University
In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System
A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University
"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH
His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.